Evaluation of the Effect of Laterality and Age on Pain Perception in Monopolar Radiofrequency Facial Therapy

Background: Monopolar radiofrequency (RF) is an established non-invasive modality for facial rejuvenation. Despite its proven efficacy, treatment-related pain remains a major barrier to patient compliance. Previous evidence suggests lateralized differences in pain perception, yet systematic evaluation in RF therapy is lacking. Purpose: To investigate laterality in pain perception during monopolar RF treatment and to explore the influence of age on pain sensitivity. Patients and Methods: A prospective study enrolled 46 patients (45 females, 1 male; age 30– 58 years) with facial laxity undergoing bilateral monopolar RF (Thermage FLX) treatment. Treatment order (left-first or right-first) was randomized, and all procedures were performed by the same right-handed physician. Pain intensity was assessed within 5 minutes post-treatment for each hemiface using a 0– 10 Visual Analogue Scale (VAS, scored to one decimal place). Results: The left hemiface exhibited significantly higher VAS scores than the right (7.12 ± 2.05 vs. 6.62 ± 1.90, p < 0.001), irrespective of treatment order. Stratified analysis revealed that younger patients (≤ 42 years) reported higher VAS scores than older patients (> 42 years) (left: 7.60 ± 1.46 vs. 6.64 ± 2.18; right: 7.07 ± 1.15 vs. 6.16 ± 2.17; both values of p < 0.05). Correlation analysis showed age was negatively associated with VAS scores. Conclusion: Monopolar RF treatment demonstrates a consistent left-side dominance in pain perception, with younger patients exhibiting greater pain sensitivity and age negatively correlated with VAS scores. Keywords: facial pain, pain laterality, age factors, Visual Analogue Scale